background *global increase in drug consumption*global increase in drug consumption *in 1998,...
TRANSCRIPT
Household Drug-Storing Practices
Among Community Residents In
Paknaan, Mandaue City, Philippines,
2010 “A Clear and Present
Danger . . . .”
Background• *Global increase in drug consumption
• *In 1998, Philippines ranked second to Singapore in terms of per capita drug consumption
• *Drug prices are 600% more expensive
• Unrestricted drug availability and use:
• Inappropriate drug use
• Drug resistance
• Drug-drug interactions
• Waste of resources
• Inappropriate disposal of expired medications* Valera, M. Experiences with Insurance Coverage of Medicines in the Philippines: Philippine Health Insurance Coverage. WHO, 2005.
• What is the epidemiology (prevalence, nature
and determinants) of the practice of household
drug-storing among the residents in Paknaan,
Mandaue City, Philippines?
• Household storage refers to the practice of
keeping drugs at home
Research Question
• Study Design: Analytical Cross Sectional Survey
• Study Setting: Paknaan, Mandaue City, Philippines, April-July 2010
• Study Population: Caregivers, household heads or any adult family member of household units
• Sampling Procedure: Proportionate sampling
• Sample Size: 80% of the total number of households within each zone
Methodology
Methodology• Maneuvers:
- house-to-house survey
- structured data collection form - questionnaire
- focus group discussion – for questionnaire development and validation of responses in filled questionnaire
• Data Analysis:
- Data were entered with Microsoft Excel Spread sheet and analyzed with SPSS ver. 16.0
- P value < 0.05 defined statistical significance
• A total of 1,209 household units (80% of total households in community)
• Respondent characteristics:• Median age: 34 years (IQR: 26 – 44)• Majority of respondents were females (77.3%)• Educational attainment: 52.9% High School• Only 21.9% were employed
• Household medication storage was high (81%)
• More prevalent in households with a family member with chronic illness - HPN, arthritis
• Medications stored in non-child proof containers
Results
Results• Most commonly stored drugs: symptom relief,
vitamins, antibiotics, anti-hypertensive agents
• Stored expired drugs: 433 (44.2%)
• Stored medicines without expiry dates: 306 (31.3%)
• Stored unlabelled medications: 126 (12.9%)
• High prevalence of OTC drug purchases (86.1%)
• Non-compliance from a prescription (29.5%)
• Mostly stored in dining room/ kitchen (53.7%)
• Most commonly thrown in garbage bin in original formulation (86.5%)
Characteristic Home Medication Storage Practice Status
P Value
Positive Negative
Age (Yrs.) 34 (IQR: 25-44) 34 (IQR: 26.8-45) 0.33
Gender (%) 0.14
Males 21.8 26.5
Females 78.2 73.5
Employment Status (%) 0.33
Employed 28.3 31.7
Unemployed 71.7 68.3
Illness in the Family (%) < 0.001
With chronic illness 65.1 31.7
Without chronic illness 34.9 68.3
Educational Attainment 0.05
Vocational (%) 2.3 0.9
College (%) 27.5 20.9
Results
Why do you store medicines at home?- “Intended for future use, in case of emergency”
- “Left over from previous prescription”
- “For remedy of common illness”
- “To avoid consulting physicians to save money”
- “Maintenance medications”
Why do you keep in kitchen/ dining room?- “Most doses are taken with meals”
Why do you store or give expired medications to others?
- “Still effective”
Why do you throw expired medications in the garbage?
- “Don’t know any other method of disposal”
Conclusion• Prevalence of household drug storage was high at
81%
• Most commonly stored drugs were symptom relievers, vitamins, antibiotics and antihypertensive medications
• Practice of household drug storage was significantly associated with presence of family member with chronic disease and level of educational attainment
• Drug storage patterns and disposal increase risk of harm to family members and community
• Patient education regarding indications and potential adverse effects of prescribed drugs
• Caution patients against medication-sharing: symptoms may be similar for many diseases of varying etiology
• Restrict and monitor Over-The-Counter (OTC) antimicrobial drug sales and drug dispensing
• Warn against potential for toxicity in children due to improper storage of medications at home
• Monitor drug advertisements in media
• Implement community drug-disposal program
Implications & Recommendations